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Flashcards in module 9 common concern of older adult 2 Deck (24)
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1
Q

vision changes associated with aging

A

dec. visual acuity: presbyopia
structural changes
floaters
reduced peripheral vision

2
Q

vision changes associated with pathology

A

cataracts
glaucoma
macular degeneratoin
retinopathy

3
Q

hearing

A
presbycusis
tinitus
ear wax 
-> social isolation
-> dec. ability to hear instructions/warnings
4
Q

touch/pain sense

A

dec. conduction speed along nerves
- loss of myelin
dec. circulation
slowed waste removal
-> dec. ability to feel injury/pressure
-> clumsy
-> difficulty with tasks

5
Q

proprioception

A

dec. conduction speed along nerves
- > difficulty with balance
- > falls,
- > dec. willingness to leave familiar places

6
Q

smell

A

dec. number of nerve endings and mucus production in nose
- > dec. enjoyment of smells and taste
- > dec. ability to smell dangerous odors

7
Q

taste

A
dec. number of taste buds 
dec sensitivity 
dec. saliva
-> dec. enjoyment of smells and tastes
-> dec. ability to taste food
-> dec. intake
-> missing bad taste of spoiled food
8
Q

cataracts risk factors

A
age
diseases
smoking
ETOH
prolonged UV exposure
9
Q

cataracts assessment

A

visual acuity
dilated eye exam
tonometry

10
Q

cataracts s/s

A
cloudy/blurry vision 
faded colors
glare/halos around lights
dec. night vision 
double vision or multiple images in one eye 
- this may improve as cataracts worsen
freq. Rx changes
11
Q

presentation of infections in elderly

A
absence of fever
sepsis w/out leukocytosis and fever
falls
dec. appetite or fluid intake
confusion 
change in functional status
12
Q

preventing falls

A
ask the 3 questions
review meds
recommend
- Vit. D
- inc. bone and muscle strength 
= improve nerve health
13
Q

polypharmacy

A

use or misuse of multiple drugs

  • Rx and Non-Rx
  • interactions with one another
14
Q

polypharmacy arises from

A
multiple comorbidities
multiple Rx'ers 
fear of accusation of ageism
cultural bias 
changing medical guidelines 
medication advertising 
treating AE of one med with another
15
Q

polypharmacy patho

A

abnml in the CV system
dec. gastric acid
dec. total body water
inc. total body fat
- all affect drug absorption and metabolism
Age related renal changes
-> inc. drug levels and potentially toxic effects

16
Q

consequences of polypharmacy

A

adverse drug reaction
change in mental status
sedation
falls

17
Q

cognitive impairment

A

decline in cognition

- most feared: dementia

18
Q

cognitive impairment AD s/s

A
  • chronic, irreversible illness with gradual onset and steady decline.
  • ST memory loss
  • disorientation, disturbance in executive functioning
  • dec. ADL function
  • aphasia, apraxia, or agnosia
  • sleep cycles reversed
  • consciousness and psychomotor changes late in disease
19
Q

cognitive impairment delirium s/s

A

acute onset
fluctuations in orientation and attention
- transient waxing and waning of LOC

20
Q

Dehydration

A

state of fluid intake deprivation and/or excess fluid loss

  • electrolyte imbalances may ensue
  • often multifactorial
21
Q

dehydration patho

A

dec. thirst response
-> inc. solute/water ratio
dec. renal plasma flow
-> dec. ability to concentrate urine
-> prevent body from retaining enough fluid
Vasopressin release stimulated by low fluid volume is diminished

22
Q

dehydration s/s

A
often vague
confusion
lethargy
rapid wt loss
functional decline
23
Q

dehydration physical exam

A

CV: orthostatic drop in BP, inc HR
temp may be elevated
mucous membranes not noticeably dry until severe dehydration

24
Q

dehydration labs

A

electrolytes (Na > 148)
BUN/creatinine ratio (>25:1)
osmolality
hgb/hct

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